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IEMbase 0229: SLC25A20-related Carnitine acylcarnitine translocase deficiency

Scope

Field Value
IEMbase ID 229
Nosology 4.1.04.01
Gene SLC25A20
External IDs OMIM:212138; ORPHA:159
Generated mapping MAPPED; Carnitine-Acylcarnitine_Translocase_Deficiency.yaml
Candidate DisMech targets Carnitine-Acylcarnitine_Translocase_Deficiency.yaml
Review date 2026-07-07

IEMbase phenotype signal

IEMbase represents this as SLC25A20-related carnitine acylcarnitine translocase deficiency. The record is autosomal recessive and treatability is marked unknown.

The biochemical rows include multiple C16-C18 long-chain acylcarnitine species, C14:0, free carnitine, creatine kinase, transaminases, hypoketotic hypoglycemia context, dicarboxylic organic acids, glucose, and lactate. Clinical rows include sudden death. Characteristic rows include severe cardiac arrhythmias, cardiomyopathy, coma, muscular-axial hypotonia, high lethality of severe phenotypes, lethargy, liver dysfunction, and skeletal myopathy. Treatments listed by IEMbase are triheptanoin/Dojolvi, glucose infusion, and MCT-enriched diet.

DisMech phenotype coverage

Carnitine-Acylcarnitine_Translocase_Deficiency.yaml is the correct target. The local entry covers biallelic SLC25A20 disease, the mitochondrial inner membrane carnitine-acylcarnitine exchanger, long-chain acylcarnitine trapping with secondary free-carnitine depletion, abnormal C16/C18 acylcarnitines and ratio indices, neonatal and infantile presentations, hypoketotic hypoglycemia, hyperammonemia, arrhythmia, cardiomyopathy, hepatic dysfunction, high mortality, newborn-screening limits, triheptanoin, MCT oil, carnitine supplementation, and acute high-rate dextrose management.

Concordance and completeness

Judgement: correct mapped target with high concordance.

IEMbase and DisMech agree on SLC25A20/CACT identity, carnitine-shuttle mechanism, long-chain acylcarnitine abnormalities, free-carnitine involvement, cardiac arrhythmia, cardiomyopathy, liver dysfunction, myopathy, lethargy/coma, severe early lethality, glucose support, MCT therapy, and triheptanoin. DisMech is richer for transport mechanism, diagnostic ratios, treatment rationale, and newborn-screening limitations.

Curation actions

  • Keep this record mapped to Carnitine-Acylcarnitine_Translocase_Deficiency.yaml.
  • No mapping correction is needed.
  • Use IEMbase as additional confirmation for sudden-death wording and granular acylcarnitine/organic-acid review rows.